Prostate Disorders

Question 1

List 4 Prostate disorders

Answer 1

Prostatitis;

• Acute
• Chronic
• Chronic non-bacterial

Benign Prostatic Hypertrophy

Question 2

What are the main pathogens causing Acute Prostatitis?

Answer 2

• E. coli
• Staph species
• Chlamydia
• N. gonorrhoeae

Question 3

How does Acute Prostatitis present?

Answer 3

• Malaise, Fever
• Dysuria
• Difficulty passing urine
• Perianal tenderness
• Soft, Tender, Enlarged Prostate on Rectal Exam

Question 4

What causes Chronic Prostatitis? (Same pathogens as for Acute)

What is the usual history?

Answer 4

• Due to inadequately treated infection
• Can be due to Antibodies not penetrating prostate effectively
• Recurrent prostatic and urinary tract infections

Question 5

Describe the most common causes of Prostatitis

Answer 5

Chronic Non-bacterial Prostatitis;

• Prostate enlargement
• No history of recurrent UTIs
• Usually due to Chlamydia
• Histology shows fibrosis (due to chronic inflammation)

Question 6

What is Benign Prostatic Hypertrophy (BPH)?

What is the suspected cause?

(Detectable in nearly all men over 60)

Answer 6

• Non cancerous prostate enlargement

- MAY be related to levels of male sex hormones

Question 7

How does BPH present?

Symptoms develop as enlarging prostate compresses prostatic urethra

Answer 7

Obstructive LUT symptoms;

• Difficulty/ hesitancy in starting to urinate
• A poor stream
• Dribbling
• Increased frequency and Nocturia

(Can lead to Hydronephrosis, and CKD)

Question 8

How does the Prostate feel on rectal examination in BPH?

Answer 8

Firm, Smooth, Rubbery

Question 9

How is BPH treated?

Answer 9

• Alpha blockers (relax smooth muscle at bladder neck and in prostate)
• Finasteride prevents conversion of testosterone to Dihydrotestosterone (an androgen)
• Surgery (TURP, Transurethral Resection of Prostate)